Provider Demographics
NPI:1932759586
Name:OLIVO-HOLZL, KARINA ELENA (MC; IBCLC 156466;)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:ELENA
Last Name:OLIVO-HOLZL
Suffix:
Gender:F
Credentials:MC; IBCLC 156466;
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:
Other - Last Name:OLIVO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MC; IBCLC
Mailing Address - Street 1:4 WOODFERN CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4925
Mailing Address - Country:US
Mailing Address - Phone:203-435-8207
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-8408
Practice Address - Country:US
Practice Address - Phone:984-974-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
L-156466101YP2500X
NCRTL23-0019390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional